A comparison of intrathecal dexmedetomidine and fentanyl as an adjuvant to 0.5% levobupivacaine in lower limb surgeries: A randomised double blind study

Spinal anaesthesia is popular and commonly used worldwide. It is economical and easy to administer and thus, commonly used technique for lower limb orthopaedicsurgeries. The advantages of a minimal drug costs, awake patient and rapid patient turnover has made this the method of choice for many surgical procedures.2 Post operative pain is common problem during lower limb orthopaedic surgeries under spinal anesthesia because spinal anesthesia using only local anesthetics is associated with relatively limited duration of action, and thus early analgesic intervention is needed in the postoperative period. So number of adjuvants, such as clonidine, fentanyl, dexmedetomidine and midazolam have been studied to prolong the spinal anesthesia effect.3

Dexmedetomidine and fentanyl are promising adjuncts to provide excellent and prolonged postoperative analgesia.5 Fentanyl is a potent synthetic opioid analgesic which is short-acting and highly lipophilic. It has been commonly used as an adjuvant to bupivacaine for postoperative analgesia.1Few studies have been done with fentanyl and dexmedetomidine as an adjuvant to levobupivacaine in obstetric patients. We have not come across any study on use of fentanyl and dexmedetomidine in lower doses as an adjuvant to levobupivacaine.

Hence, in this study we propose to compare a combination of isobaric levobupivacaine with fentanyl versus dexmedetomidine in low dose for the characteristics of spinal blockade with respect to onset, duration and hemodynamic parameters and side effect.